Breathlessness and cancer

What is normal breathing?

When you breathe in normally, a large muscle called the diaphragm tightens up and pushes down into your abdomen. This makes more space in your chest. At the same time, the muscles between your ribs pull your ribcage out and up, also making more space in your chest.

This allows your lungs to expand and fill up with air. Normal breathing is an involuntary movement. This means it happens without you thinking or willing it. Normal breathing is not difficult and does not make you tired.

Lung diagram

What is breathlessness?

If you are breathless, you tend to take short breaths in quickly. You do this using the muscles in your shoulders and chest instead of your diaphragm. But these muscles tire more easily and can even make you more breathless. When you are breathless, your breathing is tiring and difficult.

Managing breathlessness is not about taking bigger, deeper breaths. It is about controlling your breathing, no matter how fast or shallow you breathe. For this reason, you must slow down when you are breathless.

What causes breathlessness?

Breathlessness can happen gradually or suddenly.

There are many causes of breathlessness, such as:

  • Respiratory infections

  • Diseased lungs, e.g. due to lung cancer

  • Damaged lungs, e.g. due to radiotherapy, chemotherapy or other drug therapies

  • Removal of some lung tissue, e.g. surgery for lung cancer

  • Fluid around your lungs (pleural effusion)

  • Fluid in your abdomen (ascites)

  • Lung clots

  • Panic or anxiety

  • Lack of physical fitness

  • Being overweight

  • Emphysema/COPD

  • Anaemia

  • Thyroid problems

  • Heart conditions

  • Muscle weakness

  • Smoking

If you are feeling breathless or notice any change in your breathing, tell your doctor. It is important your doctor finds out the cause of your breathlessness. That way he or she can treat it properly.

Who can help my breathlessness?

There are many people who can help you to manage your breathlessness. These include the cancer liaison nurse, physiotherapist and occupational therapist. Some centres have special breathlessness clinics so your doctor can also refer you to one of these.

Your cancer doctor (oncologist) may refer you to the palliative care team. These doctors and nurses specialise in controlling your symptoms and improving your quality of life. Breathlessness can be a very common complaint for many patients with cancer. The palliative care team can help you to manage it better.

What are the symptoms of breathlessness?

The symptoms of breathlessness vary and each patient is different. They include:

  • Difficulty catching your breath

  • Noisy breathing

  • Fast, shallow breathing

  • Wheezing

  • Chest pain

Other symptoms include:

  • Pale or blue skin, especially around your mouth

  • Increase in your pulse rate

  • Cold or clammy skin

  • Flared nostrils when you breathe in

  • Feeling anxious

  • Using your shoulders and chest to breathe in

What tests do I need for breathlessness?

First, your doctor will listen to your symptoms and examine your body.

Depending on what your doctor thinks is the cause of the breathlessness, you may need the following tests:

  • Blood test 
    A blood test can give your doctor more information about your breathlessness and what is causing it. 

  • Pulmonary function tests (Breathing tests) 
    Pulmonary function tests are a group of tests that measure how well your lungs work.

  • Chest X-ray 
    A chest X-ray can check your lungs for signs of infection, damage or a build-up of fluid.

  • CT scan 
    A CT scan gives a more accurate picture of what is going on inside your body. It does this by taking many X-rays at different angles. A CT scan can help to find disease and any build-up of fluid throughout your body.

<A CT scan>

How is breathlessness treated?

It is important your doctor diagnoses the cause of your breathlessness so that you get the best treatment. For example, if you are anaemic, a blood transfusion may be the most suitable treatment. Or if you are breathless due to a chest infection, you may need antibiotics.

Other medications such as painkillers, steroids and sedatives can be used to slow down and relax your breathing. Your doctor will decide on what is best for you.

  • Getting oxygen 
    Your doctor may decide that you need oxygen regularly. The public health nurse can help to arrange home oxygen for you. Mobile oxygen cylinders are also available so that you are free to live life as normal as possible. Ask for extra tubing so that you can move around freely while on your oxygen.

  • Breathing exercises 
    Some of the best treatments for breathlessness are simple breathing exercises. Your doctor may refer you to a physiotherapist who can teach them to you. If the location of your tumour is causing your breathlessness, your doctor may treat you with chemotherapy or radiotherapy. These treatments can shrink your tumour and so improve your breathing.

Special treatments

  • Pleural fluid aspiration

  • Pleurodesis

  • Airway stenting

Your doctor will explain these treatments to you if you need them.

Quitting smoking

If you smoke, it is important that you plan to quit. Smoking can make your breathlessness worse. Speak to your medical team or find support at 

For more information on smoking, please see our Reduce your Risk section.

What exercises can improve breathlessness?

To improve your breathing, you must first become aware of how you breathe. This is a simple exercise to help you become more aware of your breathing.

Being aware of how you breathe

First, make yourself comfortable. Sitting upright with your head supported is a good position to start in. Also, make sure that you are in a quiet comfortable room where you can relax.

  1. Put one hand on your chest and one hand on your tummy.

  2. Sigh out and then breathe in through your nose and out through your mouth.

  3. The hand on your chest should barely move, while the hand on your tummy should move up and down. This is the right way to breathe, so practise it as often as you can.

Improving your breathing

Once you are comfortable with knowing how you breathe, you can concentrate on improving your breathing. This is called controlled breathing.

  1. Put your hands on your chest and your tummy as before.

  2. Sigh out. This will help you relax and drop your shoulders.

  3. Now try and make your breath out twice as long as your breath in.

  4. It helps to count it in your head: in - one, out - one, two.

  5. Continue these exercises until you are comfortable and they feel natural.

Hints & tips: Pursing your lips

  • Pursed lips are a simple but good way to control your breathing. Pursed means to press your lips together. 
  • Breathe in through your nose and out through your mouth as before. The pursed lips will slow down your breathing and help you feel in control.

It may help to make a whistle noise as you breathe out through your pursed lips. This will let you know that you are doing it right.

How does anxiety affect breathlessness?

Feeling breathless can be frightening and make you feel anxious. This is normal. But remember that anxiety can make your breathlessness worse. 

These are some simple ways to prevent you from becoming anxious:

  • Recognise when you are feeling anxious.

  • Find somewhere to sit and tell a friend what is happening.

  • Sigh out and drop your shoulders.

  • Concentrate on breathing in through your nose and out through your pursed lips.

  • Feel your tummy move as you breathe.

  • Stretch out your hands and wriggle your fingers.

  • Tell yourself that anxiety will only make you feel worse.

  • Congratulate yourself when you have overcome your feelings of anxiety.

If you would like more information on how to deal with anxiety, call our Cancer Nurseline on Freephone 1800 200 700 and speak to one of our specialist cancer nurses about counselling services and cancer support centres and groups. You can also call into a Daffodil Centre.

Coping with breathlessness

Relaxation techniques

Taking time to relax every day will help you feel less anxious. This in turn should help you feel more in control of your breathing. 

The following suggestions are simple ways to relax:

  1. Find a quiet, comfortable room.

  2. Sit upright with your head well supported.

  3. Practise your breathing awareness.

  4. Once you are happy that your breathing is in control, concentrate on your body.

  5. Start with your toes - wriggle them and relax.

  6. Now stretch out your legs and relax.

  7. Take a moment to concentrate on your tummy moving up and down as you breathe.

  8. Now sigh out and shrug your shoulders.

  9. Bend your arms and straighten.

  10. Wriggle your fingers, make a fist and relax.

  11. Feel your head relax into the chair, move it gently from side to side and feel the muscles in your neck relax.

  12. Now concentrate on your face, frown and relax.

  13. Clench your teeth, open and close your jaw and relax.

  14. Allow your body to become relaxed and at ease.

While practising your relaxation exercises, imagine you are in a place that relaxes you. This can be anywhere, for example, at a beach or in a meadow. Focus on this place and let your breathing slow down in a controlled way.

You might find complementary therapies useful when trying to relax. Many cancer support centres offer relaxation classes. Call our Cancer Nurseline on 1800 200 700 or call into a Daffodil Centre to find your local cancer support centre or for a free copy of the booklet, Understanding Cancer and Complementary Therapies.

Daily routine

Breathlessness may prevent you from doing things you normally do. Many patients become more breathless when they exert themselves. Some patients are breathless even at rest. 

Here are some ways to help you in everyday life:

  • Pace yourself. Plan plenty of rest before you exert yourself and in between tasks.

  • Think about what you need to do and prioritise. Do not worry if you cannot get everything done.

  • Ask for help when you need it.

  • You will have good and bad times of the day, so plan your activities during your good times.

It can be helpful to keep a diary of your day so that you know when you are likely to feel breathless.

  • Allow yourself more time to do tasks than it would usually take. This will take the pressure off.

  • Sit down as much as possible. For example, when washing or dressing.

  • Avoid bending down or holding your breath when stretching.

  • Use furniture or aids to lean on.

  • Be organised. Have the phone or home oxygen close by throughout the day.

Personal grooming

  • Wear loose clothing, as it is easier to put on and less restrictive.
  • Sit down as much as possible when you are washing and dressing yourself.
  • Wash yourself in warm water not hot. Steam rises from hot water and this could make it more difficult to breathe.
  • Organise yourself so all your soaps, lotions, towels and clothes are close by.

The occupational therapist in the hospital or in the community can visit your home to advise you. For example, putting up a grab rail in your bathroom might be helpful.


  • Know your limits and ask for help.
  • Plan as much as possible. For example, avoid making several trips up and down the stairs.
  • Use a trolley or bag to carry items around the house.
  • Sit down as much as possible when doing tasks.
  • Lean on furniture or aids as you move around.

The occupational therapist can also help you to adapt at home. There are many pieces of equipment to help you in your home. For example, walking aids, grab rails and pick-up sticks. If needed, your doctor can refer you to an occupational therapist or a physiotherapist.


  • Bring a friend or ask the staff to help you with your shopping.

  • Use a shopping trolley as a support.

  • Use a wheelchair or other facilities for less mobile shoppers like a power scooter.

  • Bring a trolley or backpack to avoid carrying bags in your arms.

  • Shop online or get your shopping delivered to your home.


  • Try to have a regular routine at bedtime.

  • Use a fan to help you relax at night. By moving the air around you, it can improve your breathing.

  • Try to stay upright in bed and avoid sleeping lying down.

For more information on how to manage tiredness (fatigue), visit a Daffodil Centre or contact our Cancer Nurseline 1800 200 700 for a copy of the booklet, Coping with Fatigue.

Sexual activity

  • Plan ahead and rest beforehand.

  • Stay relaxed and find a position that is comfortable for you.

  • Talk to your partner beforehand. Tell them your concerns and remember intimacy should be enjoyable and fun.

Eating and drinking

  • Drink plenty of fluids throughout the day to keep your mouth moist.

  • Eat slowly.

  • If your mouth is dry, especially from oxygen therapy, suck sweets to encourage saliva.

You may find it useful to read our booklet Diet and Cancer. Call our Cancer Nurseline on 1800 200 700 or drop into a Daffodil Centre for a free copy.

The medical social worker may be able to help with any of the above activities. They can help you get different benefits and services that you are entitled to due to your illness. They can also help with any emotional distress you might have.

Coping with an episode of breathlessness

An episode of breathlessness can be a sudden flare-up or worsening of your everyday symptoms. It helps if you feel confident to control and overcome the episode.

During an episode of breathlessness:

  • Observe your position. Sit in a chair with your feet spread shoulder-width apart.

  • Get someone to put a table in front of you with pillows on it.

  • Lean forward, fold your arms and rest your head on them.

  • Practise your controlled breathing and try to relax your arms and shoulders.

  • Stay in this position until you are comfortable that the episode is over.

You may find it more comfortable to stay standing and rest your arms and head on a windowsill. Or you might like to lie on your side, propped up by pillows. You will know what is more comfortable for you. 

If you are out walking when you suddenly become breathless, stop and stand against a wall. Let someone know that you are breathless. Keep your feet shoulder-width apart. Slump your shoulders forward and relax your arms. Stay in this position until you feel less breathless and able to move to a chair.It may be helpful to record any episodes of breathlessness you experience and let your medical team know at your next appointment. 

What should I or my family do in an emergency?

Make sure that you or your family call an ambulance when:

  • Doing controlled breathing does not improve the situation.

  • Home oxygen does not help.

  • Your breathing appears worse than usual.

  • You become blue in colour, especially around your mouth and nose.

  • Your breathlessness causes you to become drowsy or unconscious.

  • If you suddenly become breathless for the first time.

Remember you are the best judge of whether your breathing is improving or not. If you are not getting better, contact your doctor straight away.

Call our Cancer Nurseline 

Freephone 1800 200 700 and speak to one of our cancer nurses for confidential advice, support and information. It's open Monday-Thursday from 9am to 6pm and Friday from 9am to 5pm.

Date Last Reviewed: 
Wednesday, November 7, 2018